Topics
like this one sound quacky, so let's set the matter straight from the start:

If you do not like
getting shots of B-12, you should be aware that intranasal absorption is the
next best thing. Oral administration of B-12 is largely ineffective. This
goes for so-called sublingual B-12 supplements as well.

VITAMIN B-12, unlike
other B vitamins, is stored in muscle and other organs of the body. A little B-12 goes a long way, what is stored lasts a long time, and
it may take YEARS to deplete your body’s reserves. But sooner or
later, usually later (after age 40), not only do poor eating habits catch up
with us, but we also lose the ability to efficiently absorb what B-12 we do
get from food.

COBALAMIN is the proper
name for vitamin B-12. It is a really huge molecule (C 63, H 90, O 14, P,
Co). The "Co" is for the one cobalt atom at its core. B-12 is
obtained mostly, but not exclusively, by eating animal products such as dairy
and meat. If you therefore think that you have to eat meat to get your B-12,
consider this: Where do grass-and-grain-eating cattle get THEIR vitamin B-12?
From synthesis by microorganisms in their gastrointestinal tract, that's
where. And such synthesis in vegetarian animals is so tremendous that their
milk and flesh is OUR source of B-12. But it all actually came from
their bacteria.

Yes, B-12 is also
synthesized in the human GI tract, but not reliably enough for most people.
Such synthesis as occurs may be enhanced by a good vegetarian diet that
favors an internal population of beneficial, B-12 making bacteria.

But with our diets, we
will need more than they can provide. Nutritional yeast, fermented soy foods
such as tempeh, and sprouts (according to some sources) are vegetarian
sources of dietary B-12.

But there still is a
physiological hurdle to cross.

Absorption of dietary
B-12 takes place in the very last part of the small intestine, right before
the colon. Absorption requires a biochemical helper molecule called “intrinsic
factor,” which is a glycoprotein normally secreted by cells lining your
stomach. Strong stomach hydrochloric acid is also required to split up this
huge molecule. (That's why a weak acid like vitamin C (ascorbic acid) is
harmless to B-12, persistent myths to the contrary).

Incidentally, even
sublingual (under-the-tongue) B-12 supplements are probably ineffective
because the cobalamin molecule is too large to diffuse through the mucosa of
the mouth.

And if your body no
longer makes intrinsic factor like it should, you cannot absorb oral B-12
supplements very well, either.

The end result can be
pernicious anemia, which is more than the classical inability to make enough
hemoglobin for your red blood cells. Pernicious anemia also results in a sore
mouth and tongue, assorted burning and tingling sensations (paresthesia), and
eventually neurologic damage. I think Meniere’s, and dementia
symptoms mistaken for Alzheimer’s disease, might be a manifestation of
this.

While there is a urine
test for B-12 deficiency (the "isotope-dilution assay for urinary
methylmalonic acid"), to get it right it is necessary to measure the
cerebrospinal fluid, not the blood, to get accurate B-12 readings. If you are
not a Spinal Tap fan, consider a simple, non-invasive therapeutic trial of
B-12. This is so inexpensive and safe that it would be difficult to deny it
to anyone. I would suggest your doctor try a 1,000 microgram (mcg) injection
at least once a week. Compared to the US RDA of only about 3 mcg, that dose
may appear rather hefty. But given the miserable nature of Meniere’s,
erring on the high side may be preferable to unnecessarily delaying recovery.
And l know of no side effects whatsoever to B-12 overdose.

If you do not like the
idea of getting shots of B-12, you should be aware that intra-nasal (that is,
by way of the nose) absorption is the next best thing. It sounds pretty
weird, as duly promised at the beginning of this section, but it is an
efficient delivery method for large-sized molecules whether you like the
sound of it or not.

Your nose has two
choices:

1) Buy ready-to-use,
over-the-counter B-12 gel, which you will occasionally find for sale in a
pharmacy or health food store. Some products come in individual disposable
packets. These are pricey.

2) Make your own B-12
intra-nasal supplement. It is cheap, easy and best done behind closed
doors. Obtain your doctor’s OK before trying this procedure. Take any
B-12 tablet (between 100 to 1,000 mcg) and grind it into a powder between two
tablespoons. Add water, just a few drops at a time, to make a soft
paste. With a “Q-Tip,” its generic equivalent, or your
clean pinkie finger, gently swab the paste inside your nose up to a
comfortable level. Do not push; use no force whatsoever. The excipients
(tableting ingredients) are more likely to bother your schnoz than the B-12
is. If it irritates you, try using less, or a different brand of
tablet. I’d try this two times a week for a month or two.

Feel free to quit at any
time, and get B-12 shots instead. Once in a great while, doctors
(such as “Children’s Doctor” Lendon H. Smith, M.D.) will even
teach you how to give yourself your B-12 shots, but that remains a singularly
rare event.

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